Isaac Baker Brown

Isaac Baker Brown, circa 1851

Isaac Baker Brown (* 1811 in Colne Engaine , Essex , † February 3, 1873 in London ) was a well-known British gynecologist and obstetrician . For a period of around three decades he had the reputation of being a specialist in women's diseases . He was one of the first British gynecologists to use chloroform and developed a number of surgical methods to alleviate women's ailments. At the same time, in 1866, in his work on the "curability of various forms of madness , epilepsy , catalepsy and hysteria in women", he propagated various surgical interventions, including clitoridectomy as a treatment method. His career ended shortly after this book was published because he was accused of unprofessional behavior.

Life

Baker Brown was born in Colne Engaine, Essex, in 1811. His parents were the farmer of the same name Isaac Baker Brown and Catherine Boyer, the daughter of a school teacher. Baker Brown attended school in Halstead, Essex, and then apprenticed to a doctor named Gibson. He studied at Guy's Hospital , London, where he specialized in obstetrics and gynecological diseases. He married Anne Rusher Barron on June 18, 1833 and, after her death, Catherine Read on May 21, 1863.

Career advancement

Baker Brown began practicing medicine in London from 1834. His career began at a time when doctors were gradually beginning to specialize in individual specialties.

Baker Brown was one of the first doctors to see themselves as gynecologists. At the same time, he was an extremely daring surgeon compared to the gynecologists of the 1850s. He was one of the first to use chloroform during childbirth and surgical procedures. Among other things, he developed new surgical techniques to heal abdominal fistulas. His technical skills made him one of the most recognized doctors in London. However, historian Andrew Scull also points out that few were so willing to risk their patients' lives: despite the deaths of his first three patients, he experimented with ovariectomy , the surgical removal of one or two ovaries, as a treatment for various ailments.

St. Mary's Hospital; Foundation stone laid by Prince Albert

Back in 1848, Baker Brown was elected a member of the Royal College of Surgeons of England and his operating room became, in the admiring words of Thomas Wakley, then editor of The Lancet magazine , the place other colleagues went to for further training. The publication of On some Diseases of Women Admitting of Surgical Treatment , a surgical manual, and his role in founding St Mary's Hospital were other milestones in his career culminating in the 1865 election as President of the Medical Society of London . In 1858 he gave up his connection with St Mary's Hospital and founded his own clinic, the London Home for Surgical Diseases of Women .

Like many of his gynecological colleagues, Baker Brown was repeatedly denied success with patients who, in addition to physical complaints, also suffered from neurotic complaints, which in the jargon of the time were known as hysteria . In 1858 he read one of the sensational lectures by the physiologist and neurologist Charles-Édouard Brown-Séquard , which had been published in The Lancet under the title The Physiologist and Pathology of the Central Nervous System . Baker Brown deduced from this for his own practice that the reason for the hysteria and other nerve ailments of his patients was that they masturbated. The thesis that masturbation was the cause of hysteria and other forms of mental illness was a common thesis in psychiatry in the first half of the 19th century. A "campaign against masturbation" has been taking place across Europe since the 18th century. Countless scientific and popular science publications have appeared denouncing the alleged dangers of masturbation and offering methods of preventing it. Isaac Brown Baker went further than his peers, however, describing the proposed measures as half-hearted and in his work On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females , published in 1866 , avowed himself as a surgical test on the clitoris in women as "source of these excitements" to have removed. He came to the conclusion that the surgical intervention led to an immediate improvement in mental state.

Professional decline

Despite these alleged successes and although Baker Brown's approach conformed to central ideas of Victorian medical theory, the publication of his theses ended his career in 1866. Andrew Scull points out in his story of hysteria that it was not the brutality of the intervention that caused this career dropout. Even before his book was published in 1866, his behavior had been criticized in the specialist press of the time. In the middle of the 19th century, it was still a matter of dispute in Great Britain whether medical professionals could claim the social status of a “gentleman”, and the medical profession was therefore extremely sensitive to behaviors that threatened the fragile social status of their professional group. Baker Brown's wrongdoing consisted of repeatedly and very deliberately wooing the attention of the British public. For example, at the beginning of 1866 he had arranged for a very benevolent article about his clinic to appear in the Evening Standard newspaper . The article drew a sharp comment from the editor of the British Medical Journal :

"We doubt that the medical community will approve of the way this institute presents itself to the public ... superfluous self-congratulation is not always a true recommendation."

Baker Brown ignored the hint. A few editions later, the British Medical Journal repeated its attack: the current annual report of Baker Browns Surgical Home was permeated with a regrettable spirit of exaggeration. In his book, published that year, the British Medical Journal approved that some of the proposed surgeries had value. At the same time, however, in its book review it criticized the fact that it made exaggerated and unsubstantiated claims. Worse still, the book is apparently not only aimed at a professional audience, but is written in a way that suggests it is intended for a wider readership. The impression that Baker Brown was more concerned with the approval of the public than with that of his peers was underscored a little later by the fact that the Church Times , a church weekly, published an article that positively assessed his operations and suggested that pastors consider him to recommend to their parishioners. In December 1866, the Times again published an article launched by Baker Brown, which positively valued his method of curing mental illness. Not long afterwards it became known that Baker Brown had sent his clinic's annual report to a number of influential figures. It was this repeated breach of behavioral norms that ultimately led all influential medical professionals to turn against Baker Brown, who had recently been counted among the leading doctors in Great Britain. A little later he was expelled from the Obstetrical Society , an association of British gynecologists.

According to Michael Clark, the harsh condemnation that Baker Brown faced is due to the fact that the profession of academically trained physician, and in particular the profession of gynecologist, was still comparatively young. Their claim to authority and reputation could only be upheld if they showed morally impeccable behavior that was always aimed at the welfare of their patients. Any behavior that deviated from this ran the risk of undermining their professional standards. Isaac Baker Brown's behavior, more reminiscent of a shopkeeper's advertising, went against all professional standards.

Publications

• 1854: On some Diseases of Women Admitting of Surgical Treatment
• 1866: On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females

literature

• Andrew Scull: Hysteria - The Disturbing History , Oxford University Press, Oxford 2009, ISBN 978-0-19-969298-9

Single receipts

1. ^ Isaac Baker Brown: On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females. , Hardwicke 1866. Full text
2. ↑ Elizabeth Sheehan: Victorian Clitoridectomy: Isaac Baker Brown and his Harmless Operative Procedure . In: Medical Anthropology Quarterly 12, No. 4, 1981, pp. 9-15. doi: 10.1525 / maq.1981.12.4.02a00120 .
3. ^ Scull: Hysteria , p. 74.
4. ^ Scull: Hysteria , p. 76.
5. ↑ Scull: Hysteria , p. 76. In the original, Walken described Baker Brown's surgery as one of the most attractive to the professional visitor in all London - admiration being invariable evoked by his brilliant dexterity and the power he displayed in the use of his left hand when operating on the female perineum.
6. ↑ ^{a b c} Saul: Hysteria , p. 77.
7. ↑ ^{a b} Saul: Hysteria , p. 78.
8. ↑ Quoted from Andrew Scull: Hysteria , p. 80. The original quote is: We doubt whether the Profession will approve of the way in which this particular institution is brought before the public ... A superfluous amount of self-laudation is not always a real recommendation.
9. ^ Scull: Hysteria , p. 80.
10. ↑ This process was also made public by the British Medical Journal . In the words of the article, Baker Brown sent his annual report to helped the nobility in the kingdom . BMJ, February 9, 1867
11. ^ Scull: Hysteria , p. 81.
12. ^ Scull: Hysteria , p. 83.
13. ↑ Michael Clark; The Rejection of Psychological Approaches to Mental Disorder in Late Nineteenth Century British Psychiatry. in A. Scully (Editor): Madhouses, Mad-Doctors, and Madmen. , Athlone, London 1981, p. 293
14. ^ Scull: Hysteria , p. 82.